Highlights
- •Diabetes is a risk factor for kidney cancer among non-obese post-menopausal women.
- •Time-dependent diabetes is associated with kidney cancer risk among post-menopausal women with a BMI < 30 kg/m2.
- •Time-dependent diabetes is associated with kidney cancer risk among post-menopausal women with a waist circumference <34.6 in..
Abstract
Background
Many studies have reported a positive association between diabetes and kidney cancer.
However, it is unclear whether diabetes is a risk factor for kidney cancer independent
of other risk factors, such as obesity and hypertension. We comprehensively examined
the association of diabetes and its duration with incident kidney cancer in the prospective
cohort Iowa Women’s Health Study (1986–2011).
Methods
Diabetes status was self-reported at baseline (1986) and on five follow-up questionnaires.
Cox proportional hazards regression was used to calculate hazard ratios (HRs) and
95% confidence intervals (CIs) for the associations of baseline and time-dependent
diabetes with the risk of incident kidney cancer.
Results
During the 25 years of follow-up, 245 cases of kidney cancer occurred among 36,975
post-menopausal women. In an age-adjusted model, there was a significant association
between time-dependent diabetes and the risk of kidney cancer [HR (95% CI) = 1.76
(1.26, 1.45)]; the association was attenuated after multivariable adjustment for age,
body mass index (BMI), waist-to-hip ratio (WHR), hypertension, physical activity,
diuretic use, pack-years of smoking, alcohol intake, and total caloric intake [HR = 1.35
(0.94, 1.94)]. However, among non-obese women or women with a waist circumference
less than 34.6 in., diabetes was significantly associated with kidney cancer risk:
for time-dependent diabetes, HRs (95% CIs) were 1.82 (1.10, 3.00) among those with
BMI < 30 kg/m2 and 2.18 (1.08, 4.38) among those with a waist circumference <34.6 in..
Conclusions
Our results suggest that diabetes is associated with kidney cancer risk among non-obese
post-menopausal women.
Keywords
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Article info
Publication history
Published online: August 11, 2020
Accepted:
July 28,
2020
Received in revised form:
June 22,
2020
Received:
December 9,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
